Maintenance treatment

Patients who have made a good recovery from a first episode of schizophrenia may be able to taper off their medication after a few months. Those who have persistent symptoms or frequent relapses will usually be advised to stay on long-term medication. However, long-term therapy carries a higher risk of side-effects, so it needs to be monitored carefully, and the dose kept at the minimum necessary for symptom control.

Patients who have done well on small doses of medication can be considered for a trial of seeing whether they can do without it completely. However, this will depend on what the patient wants; some patients who have been very unwell in the past, rightly fear the return of symptoms and prefer to carry on with long-term medication. If, however, they wish to see whether they can do without medication, they will require close monitoring during the trial period; it will be necessary to restart the medication straightaway if symptoms re-emerge.

In general, patients who have a clear history of schizophrenia, and who are doing well on a small dose of medication that is not causing side-effects, are probably best advised to stay on it indefinitely unless they have strong wishes to the contrary.

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